A large proportion of cardiac disease cases involve occlusions of the coronary arteries which become sufficiently servere to cause angina, infarction, and ultimately, death. One of the most effective therapies for occlusive coronary disease is the coronary bypass surgical procedure, in which a section of vascular tissue is harvested from the patient and grafted between the aorta and the coronary artery or arteries to bypass the occluded portion(s) of the artery. Attesting to the effectiveness of this procedure is the fact that more than 250,000 coronary bypass procedures are undertaken annually in the United States alone, and many more hundreds of thousands of procedures are conducted worldwide.
The technique routinely used to gain access to the heart to install the bypass grafts involves opening the chest, cutting the sternum longitudinally and spreading the sternum laterally to open a pathway to the pericardium. After the grafts are installed, the sternum is rejoined and the skin and fascia are sutured to close the surgical wound. Joining the severed halves of the sternum is a major task, and is usually accomplished using strong metal wire similar in strength and diameter to piano wire. A large curved needle is employed to drive the wire through one half of the sternum adjacent to the cut edge, across the gap and up through the other half of the sternum. Thereafter the two ends of the wire are pulled to urge the two halves together, the wires are twisted to maintain the closure, and the excess wire is cut and removed. Generally speaking, from five to seven wire sutures are required to close the sternum, and this portion of the procedure may take as long as one-half hour.
It is a basic tenet of surgical practice that the longer a patient remains on the operating table, there is a statistically greater chance of complications and death. Therefor, it would be extremely beneficial to shorten the time required to close the sternum. However, there is no better and faster technique known in the prior art for rejoining the sternum.
In addition to coronary bypass surgery, there are many other surgical procedures that require opening the chest and cutting and rejoining the sternum in the same manner as coronary bypass procedures. These procedures would also benefit from an improved technique to close the sternum.